Kangaroo mother care (KMC) for procedural pain in infants: A meta-analysis from the current evidence of randomized control trials and cross-over trials.

Abstract

Kangaroo mother care (KMC), which is also known as Skin-to-skin (STS) care, is supposed to be effective in alleviating the pain of the neonates occurring during various procedures carried out in routine medical care or during the medical examination. The meta-analysis aimed to determine the effect of the kangaroo mother care method on procedural pain in infants receiving KMC to those receiving only standard care (SC). For this meta-analysis, a systematic literature search was conducted in online database PubMed, Medline, Web of Science, Google Scholar, and the CENTRAL database using MESH terms such as kangaroo mother care method/classification, kangaroo mother care method, kangaroo mother care method/instrumentation, kangaroo mother care method/methods, pain threshold, pain, pain management/methods, pain management/instrumentation, pain management/therapy, and pain management/therapeutic with the help of Boolean terms. Only randomized control trials or cross-over trials published within ten years and reporting pain assessment during or within five minutes of the pain stimulating procedure assessed using Premature Infant Pain Profile (PIPP) score were considered. The primary outcome measures were procedural pain assessed by PIPP score and reported in mean and standard deviation along with 95% confidence interval (CI). In cross-over trials, data were taken from the first phase, i.e., before cross-over. The pooled estimate of the six studies revealed a potential statistically significant benefit of KMC over SC in pain reduction following a pain stimulating procedure (<i>P =</i> 0.01, Mean difference = -2.04, 95% CI: -3.65, -0.43, Chi² = 69.86, I² = 93%). A high level of heterogeneity was found, i.e., 93%. Kangaroo mother care seems to be an effective intervention in alleviating the procedural pain due to routine procedures or medication examination.